A decade of progress since NMSQuest

The past decade has seen a quiet revolution in our understanding of Parkinson’s Disease (PD), which is promising to transform the way in which we approach the care of patients with this debilitating condition. Our understanding of the relevance of non-motor symptoms (NMS) to the clinical manifestations of PD has increased dramatically since the development of NMSQuest, the first-ever patient-empowered tool for measuring NMS in PD.  So too has our recognition of the significant impact of NMS on patient morbidity, caregiver burden and health-related quality of life.

This was the overriding message from the two-day meeting (3-4 March 2016) convened in Madrid (Spain) by leading neurologists Professor K Ray Chaudhuri from King’s College London and Dr. Pablo Martínez-Martín from Carlos III Institute of Health in Madrid. The meeting, ‘Measuring Non-Motor Symptoms of Parkinson’s Disease: 10 years since NMSQuest’, featured keynote presentations from some of the world’s most distinguished neurologists and neuroscientists including the President of the International Parkinson and Movement Disorder Society (MDS), Professor Oscar Gershanik.

There is now overwhelming consensus that PD is a multisystem neurodegenerative process featuring both motor and non-motor symptoms. However, recognition of the non-motor features of a PD patient’s profile has generally been poor in clinical practice, a fact that provided a consistent backdrop to discussions at the meeting. But the NMS field is fast evolving – alongside the wealth of data presented to demonstrate the widening utility of screening tools and scales such as NMSQuest and NMS Scale (NMSS), speakers elucidated on progress with subtyping PD patients according to NMS phenotypes, the identification of biomarkers that may allow for earlier – preclinical – identification of neuronal loss, the potential of imaging studies to investigate the multiple pathologies of PD, and the genetic basis of non-motor manifestations.

Meeting delegates were engaged with an analysis of individual NMS, including pain, fatigue, apathy, mood changes and gastrointestinal dysfunction. Researchers are pursuing the potential for the early (pre-motor) identification of NMS, their changing characterisation with disease progression, more user-friendly and specific assessment tools, and the therapeutic consequences of improved NMS characterisation.